What Is an Intestinal Obstruction?
Intestinal obstructions are a potentially serious condition where the intestines are blocked. If blockage occurs, food and drink cannot pass through the body. Both the small intestine and large intestine (colon) can be affected. Obstructions are considered an emergency and may require surgery.
Intestinal obstruction is the partial or complete blockage of the
intestines at one or more locations. Obstructions prevent liquids and solids
from passing through the digestive tract. There are a variety of causes. These
can include mechanical blockages, swallowed objects, infections, and nervous
This can be an emergency. If the intestines are blocked, that part of
the intestine can die. Dehydration can also be a dangerous complication.
What Causes Intestinal Obstruction?
Obstruction can be partial, which may resolve without surgery. A complete
blockage will likely need intestinal surgery.
Mechanical obstructions physically block the small intestine. This can
be due to:
fibrous tissue that develops after abdominal surgery
twisting of the intestines
“telescoping” or pushing of one segment of intestine into the next section
of the intestine in newborns
within the small intestine
objects (especially in children)
a portion of the intestine that protrudes outside of the body or into another
part of the body
bowel disease such as Crohn’s disease
Though rare, mechanical obstructions can also block the colon (large
intestine). This can occur due to:
plug in newborns
inflammation or infection of bulging pouches of intestine
narrowing caused by scarring or inflammation
Non-mechanical obstruction can occur when the muscles or nerves within
the small or large intestine no longer function. This is called paralytic ileus. The intestines work in
a coordinated system of movement. If something interrupts these coordinated
contractions, it can cause a functional intestinal obstruction. Causes for
paralytic ileus include
or pelvic surgery
like gastroenteritis or appendicitis
opioid pain medications, antidepressants, and antimuscarinic medications
potassium levels, other mineral/electrolyte imbalances
disease and other nerve and muscle disorders
disease (lack of nerves in a section of intestine in newborns)
Symptoms of Intestinal Obstruction
Unfortunately, the symptoms of intestinal obstruction are common to a
variety of problems. It takes time and testing to determine whether or not an
intestinal obstruction exists.
Symptoms can include:
- severe abdominal pain
- cramps that come in waves
- nausea and vomiting
- constipation, or inability to have a
- inability to pass gas
- distention or swelling of the
- loud noises from the abdomen
- foul breath
How Is Intestinal Obstruction Diagnosed?
First a doctor may push on the abdomen. They will then listen with a
stethoscope to any sounds being made. The presence of a hard lump or the
particular kinds of sound produced, especially in a child, may help determine
whether or not an obstruction exists. Other tests include:
- Computed tomography
- CT Scan
with contrast (CT enterography)
What Are Treatments for Intestinal Obstruction?
Treatment must be rapid to prevent complications like:
forming in the intestines (perforation)
If the obstruction is preventing blood from getting to a segment of
intestine, this can lead to infection, tissue death, or gangrene. In newborns
or premature infants, there is a worry that paralytic ileus can become necrotizing entercolitis, a potentially
fatal die-off of the intestinal walls.
Treatment depends on the location and severity of the obstruction. For
partial obstructions, it may be possible to give a low-fiber diet and wait for the
obstruction to pass.
Treating dehydration is important. IV fluids may be started to correct
electrolyte imbalance. A catheter may be inserted into the bladder to remove
In some cases, a tube can be passed through the nose and down into the throat,
stomach, and intestines to relieve pressure, swelling, and vomiting. Surgery
may still be required after this procedure.
For some patients, a metal stent that expands inside the intestine may
be placed using a long tube called an endoscope. This wire mesh holds open the
intestine. The procedure may not require cutting into the abdomen.
Paralytic ileus may get better without surgery. A patient may be
monitored for a few days in the hospital before any surgery is attempted.
Medications to improve muscle contractions may be administered.
If the obstruction is mechanical and no other options are available, the
abdomen may be cut into. The affected section of intestine is then repaired or
removed, and the surrounding intestine reattached.